Provider Demographics
NPI:1780284505
Name:BELLO, SULAIMAN BABATUNDE
Entity type:Individual
Prefix:DR
First Name:SULAIMAN
Middle Name:BABATUNDE
Last Name:BELLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TX HWY 6
Mailing Address - Street 2:
Mailing Address - City:MARLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76661
Mailing Address - Country:US
Mailing Address - Phone:254-883-9296
Mailing Address - Fax:
Practice Address - Street 1:600 TX HWY 6
Practice Address - Street 2:
Practice Address - City:MARLIN
Practice Address - State:TX
Practice Address - Zip Code:76661
Practice Address - Country:US
Practice Address - Phone:254-883-9296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI48213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist